AB0888 Guselkumab Provides Sustained Improvements in Work Productivity and Daily Activity in Patients With Active Psoriatic Arthritis Through 2 Years of DISCOVER-2
Authors: J. Curtis, I. Mcinnes, P. Rahman, D. D. Gladman, F. Yang, S. Peterson, A. Kollmeier, N. Shiff, C. Han, M. Shawi, W. Tillett, P. J. Mease
Journal: Annals of the Rheumatic Diseases (2022)

Background Psoriatic arthritis (PsA) impacts patients’ (pts) work productivity (WP) and daily activity. 1 DISCOVER-2 (D2), a Phase 3 trial of the selective interleukin-23 p19-subunit inhibitor guselkumab (GUS) in biologic-naïve pts with PsA, 2 demonstrated significant improvements in pt-reported WP and daily activity following 1 year (Y) of GUS treatment. 3 Objectives Assess WP and daily activity impairment in D2 pts through 2Y. Estimate indirect savings associated with GUS treatment and assess changes in employment status. Methods Pts with active PsA received GUS 100 mg every 4 weeks (Q4W); GUS 100 mg at W0, W4, then Q8W; or placebo (PBO). At W24, PBO pts crossed over to GUS 100 mg Q4W. WPAI-PsA assesses PsA-related work time missed (absenteeism), impairment while working (presenteeism), and impaired overall WP (absenteeism + presenteeism) for pts employed at baseline (EBL) and daily activity for all pts, including those unemployed at baseline (UBL) during the previous week. Mean changes in WPAI-PsA domains were calculated for each multiple imputation (MI) dataset using an analysis of covariance (ANCOVA); the reported LS mean is the average of all MI datasets. Significance was defined as p&lt;0.05. Among pts EBL, potential indirect savings from improved overall WP were estimated using 2020 European Union mean yearly wage estimate (all occupations) combined with LS mean change from BL in WPAI-PsA overall work impairment. 4 A shift analysis evaluated proportions of pts employed vs unemployed by treatment group using observed data over time. Results Pts EBL comprised 64% of the analysis cohort. Significant improvements in WP in pts EBL and in daily activity among all pts were observed with GUS Q4W/Q8W vs PBO at W24; 3 mean improvements in WP and daily activity increased with continued GUS through 2Y (Table 1). Potential annual indirect savings from improved overall WP in pts EBL were €10,826 GUS Q4W, €12,712 GUS Q8W, and €10,948 PBO→ GUS Q4W at 2Y. Shift analysis showed relatively stable employment in pts EBL with GUS up to 2Y (&gt;83% continued to work). Among pts UBL (36% of cohort), the proportion of pts employed increased by &gt;20% through 2Y of GUS (Figure 1). Table 1. Model-Based Estimates of Change From BL in WPAI-PsA Domains 1 GUS 100mg Q4W GUS 100mg Q8W PBO (W0-24) → GUS 100 mg Q4W (W24-100) Visit W24 W100 W24 W100 W24 W100 Absenteeism, N 145 147 147 149 162 166 LS Mean (95% CI) -3.4 (-6.5, -0.3) -1.8 (-4.5, 0.9) -3.0 (-6.0, 0.1) -4.2 (-6.8,-1.5) -3.0 (-6.0, 0.04) -4.2 (-6.8,-1.6) Diff vs. PBO -0.4 (-4.6, 3.8) - -0.01 (-4.2, 4.2) - - - Presenteeism, N 145 147 147 149 162 166 LS Mean (95% CI) -20.1 (-23.7, -16.6) -26.3 (-30.1,-22.5) -19.6 (-23.2, -16.1) -28.0 (-31.8, -24.2) -10.5 (-13.9, -7.0) -24.2 (-27.9, -20.5) Diff vs PBO -9.7* (-14.4, -5.0) - -9.2* (-13.9, -4.5) - - - Work productivity, N 145 147 147 149 162 166 LS Mean (95% CI) -20.1 (-24.1, -16.1) -23.8 (-28.0, -19.6) -19.2 (-23.1, -15.2) -28.0 (-32.1, -23.8) -10.6 (-14.4, -6.8) -24.1 (-28.1, -20.1) Diff vs PBO -9.5* (-14.8, -4.2) - -8.6* (-13.9, -3.3) - - - Daily Activity, N 242 242 246 246 245 245 LS Mean (95% CI) -20.5 (-23.3, -17.7) -29.2 (-32.2, -26.1) -21.2 (-23.9, -18.4) -28.0 (-31.0, -24.9) -9.9 (-12.6, -7.1) -26.6 (-29.6, -23.6) Diff vs PBO -10.6* (-14.4, -6.8) - -11.3* (-15.1, -7.5) - 1 Mean changes in WPAI-PsA domains were calculated for each MI dataset using an ANCOVA; reported LS mean (95% confidence interval [CI]) = average of all MI datasets. *p&lt;0.002 Conclusion In GUS-treated bio-naïve PsA pts, robust improvements in WP and daily activity seen at W24 were maintained and increased through 2Y of GUS. Long-term improvements in WP achieved may result in substantial indirect cost savings for GUS-treated pts. Rates of employment remained stable in pts employed and increased in those unemployed at BL. References [1]Tillett W et al. Rheumatol (Oxford). 2012;51:275–83. [2]Mease PJ, et al. Lancet. 2020;395:1126–36. [3]Curtis JR et al. EULAR, June 2–5, 2021. POS1026. [4]OECD (2020). Average wages (indicator). https://data.oecd.org/earnwage/average-wages.htm Disclosure of Interests Jeffrey Curtis Consultant of: AbbVie, Amgen, Bristol-Myers Squibb, CorEvitas, Eli Lilly and Company, Janssen, Myriad, Novartis, Pfizer, Sanofi, and UCB, Grant/research support from: AbbVie, Amgen, Bristol-Myers Squibb, CorEvitas, Eli Lilly and Company, Janssen, Myriad, Novartis, Pfizer, Sanofi, and UCB, Iain McInnes Shareholder of: Causeway Therapeutics, and Evelo Compugen, Consultant of: Astra Zeneca, AbbVie, Bristol-Myers Squibb, Amgen, Eli Lilly and Company, Cabaletta, Compugen, GSK, Gilead, Janssen, Novartis, Pfizer, Sanofi, Roche, and UCB, Grant/research support from: Astra Zeneca, Bristol-Myers Squibb, Amgen, Eli Lilly and Company, GSK, Janssen, Novartis, Roche, and UCB, Proton Rahman Consultant of: AbbVie, Amgen, Bristol Myers Squibb, Celgene, Eli Lilly, Janssen, Merck, Novartis, Pfizer, and UCB, Grant/research support from: Janssen and Novartis, Dafna D Gladman Consultant of: Abbvie, Amgen, BMS, Eli Lilly, Galapagos, Gilead, janssen, Novartis, Pfizer and UCB., Grant/research support from: Abbvie, Amgen, Eli Lilly, Janssen, Pfizer, UCB, Feifei Yang Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Global Services, LLC, Steve Peterson Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Global Services, LLC, Alexa Kollmeier Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development, LLC, Natalie Shiff Shareholder of: Johnson &amp; Johnson, Abbvie, Gilead, Employee of: Janssen Scientific Affairs, LLC, Chenglong Han Shareholder of: Johnson &amp; Johnson, Employee of: Janssen Research &amp; Development, LLC, May Shawi Shareholder of: Johnson &amp; Johnson, Employee of: Immunology Global Medical Affairs, Janssen Pharmaceutical Companies, William Tillett Speakers bureau: Abbvie, Amgen, Eli-Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Consultant of: Abbvie, Amgen, Eli-Lilly, Janssen, MSD, Novartis, Pfizer, and UCB, Grant/research support from: Abbvie, Amgen, Eli-Lilly, Janssen, and UCB, Philip J Mease Speakers bureau: AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Consultant of: AbbVie, Aclaris, Amgen, Boehringer Ingelheim, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, GlaxoSmithKline, Inmagene, Janssen, Novartis, Pfizer, Sun Pharma, and UCB, Grant/research support from: AbbVie, Amgen, Bristol Myers Squibb, Eli Lilly, Galapagos, Gilead, Janssen, Novartis, Pfizer, Sun Pharma, and UCB